Acute promyelocytic leukemia

Kantarjian, Hagop M.; Keating, Michael J.; Walters, Ronald S.; Estey, Elihu H.; McCredie, Kenneth B.; Smith, Terry L.; Dalton, Willard T.; Cork, Ann; Trujillo, José M.; Freireich, Emil J.

doi:10.1016/0002-9343(86)90617-0

Cited by 194 publications

(35 citation statements)

References 27 publications

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“…When DIC is associated with microvascular thromboses resulting in digital or renal ischemia, emergent moderate dose (5-10 u/kg/hr) heparin therapy is indicated. Moderate-dose heparin has also become part of the standard induction chemotherapy program for acute promyelocytic leukemia [6]. Rarely is full-dose heparinization warranted, with the exception of DIC associated with pulmonary embolism…”

Section: Discussionmentioning

confidence: 99%

Therapy of the Kasabach‐Merritt syndrome with cryoprecipitate plus intra‐arterial thrombin and aminocaproic acid

et al. 1991

American J Hematol

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A patient with the Kasabach-Merritt syndrome with disseminated intravascular coagulopathy and congestive heart failure due to a giant hepatic cavernous hemangioma achieved thrombosis of his tumor with a combination of cryoprecipitate plus intra-arterial thrombin and epsilon aminocaproic acid. This was documented by an absence of Indium 111-labelled platelet sequestration, marked decrease in thrombin:antithrombin complex generation, and normalization of platelet count and fibrinogen. Interventional angiography with aminocaproic acid and thrombin is advocated in patients whose tumors are amenable to such an approach so as to avoid a systemic antifibrinolytic state.

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Section: Discussionmentioning

confidence: 99%

Therapy of the Kasabach‐Merritt syndrome with cryoprecipitate plus intra‐arterial thrombin and aminocaproic acid

et al. 1991

American J Hematol

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“…In patients with APL, the bleeding risk and platelet transfusional requirements remain also higher in the retinoic acid era [5]. In this type of leukemia the correction of thrombocytopenia with platelet transfusion is of special value, as demonstrated by different studies [68, 69]. In our experience, in a series of 65 adults with APL, the CR rate was higher in patients transfused intensively with platelets and not given heparin [70].…”

Section: Management Of the Apl Coagulopathymentioning

confidence: 93%

Coagulopathy of Acute Promyelocytic Leukemia

Falanga

Barbui²

2001

Acta Haematol

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Life-threatening bleeding is frequent in acute leukemias, particularly in acute promyelocytic leukemia (APL), a distinct subtype of acute myelogenous leukemia, characterized by the balanced reciprocal translocation between chromosomes 15 and 17. Laboratory assessments show profound hemostatic imbalance compatible with the clinical picture of disseminated intravascular coagulation. Activation of the coagulation system, hyperfibrinolysis and nonspecific proteases activity can be observed in this condition. An important pathogenetic role is attributed to the leukemic cell properties for activating hemostatic mechanisms. This review will summarize what is currently known about the coagulopathy of APL, the principal pathogenetic mechanisms, and the therapeutic tools for the management of this complication. Special attention will be devoted to the new therapy with all-trans retinoic acid, which has completely changed the natural history of APL and APL-related coagulopathy.

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“…To our knowledge, 9q deletion has been described previously in 9 cases of de novo APL [11,[15][16][17][18] but not in t-APL. Reported here is an unusual case of t-APL following RAI exposure with an interstitial deletion of 9q in addition to the pathognomonic t (15:17).…”

Section: Discussionmentioning

confidence: 99%